特发性血小板减少性紫癜患儿糖皮质激素受体研究

Expression of glucocorticoid receptors in children with idiopathic thrombocytopenic purpura

目的探讨糖皮质激素受体(GR)在特发性血小板减少性紫癜(ITP)儿童外周血淋巴细胞的表达与临床意义。方法采用流式细胞术分别测定17例急性ITP、23例慢性ITP和20例正常儿童细胞内受体(iGR)与膜受体(mGR)水平。结果ITP组mGP和iGR水平均高于正常儿童组(P<0.01),急性ITP组和慢性ITP组间mGR差异无显著性(P>0.05),急性ITP组iGR水平高于慢性组(P<0.05)。结论mGR、iGR均可能在ITP的发病机制中起重要作用,iGR的表达可能更重要;iGR低者更易发展成慢性患者,iGR水平可作为预测ITP预后的一项参考指标。

Objectives To evaluate the expression of glucocorticoid receptors （GR） in peripheral blood lymphocytes and their clinical significance in children with idiopathic thrombocytopenic purpura （ITP）. Methods The study included 17 children with acute ITP,23 children with chronic ITP and 20 healthy volunteers. The expressions of membrane-associated GR （mGR） and intracellular GR （iGR） in peripheral blood lymphocytes were detected by flow cytometry. Results The expressions of both mGR and iGR were higher in children with ITP than in healthy control （P〈0.01）. There was no significant difference of mGR expression between acute and chronic ITP children （P〉0.05）, while the iGR level was significantly higher in children with acute ITP than with chronic ITP （P〈0.05）. Conclusions Both mGR and iGR may play an important role in the pathogenesis of ITP. The expression of iGR may be relatively more important because ITP patients with low level of iGR may be more liable to develop into chronic course. The iGR level could be used as a reference marker for the evaluation of prognosis in children with ITP.